Hostname: page-component-7c8c6479df-24hb2 Total loading time: 0 Render date: 2024-03-29T08:33:07.619Z Has data issue: false hasContentIssue false

Validation of the Brief Edinburgh Depression Scale (BEDS) in a Mexican population with advanced cancer in a palliative care service

Published online by Cambridge University Press:  26 September 2018

Oscar Rodríguez-Mayoral*
Affiliation:
Palliative Care Unit, Instituto Nacional de Cancerología, México City, Mexico
Bárbara Rodríguez-Ortíz
Affiliation:
Hospital Psiquiátrico “Fray Bernardino Álvarez,” México City, México
Leticia Ascencio-Huertas
Affiliation:
Palliative Care Unit, Instituto Nacional de Cancerología, México City, Mexico
Adriana Peña-Nieves
Affiliation:
Palliative Care Unit, Instituto Nacional de Cancerología, México City, Mexico
Emma Verástegui
Affiliation:
Palliative Care Unit, Instituto Nacional de Cancerología, México City, Mexico
Silvia Allende-Pérez
Affiliation:
Palliative Care Unit, Instituto Nacional de Cancerología, México City, Mexico
Mari Lloyd-Williams
Affiliation:
Academic Palliative and Supportive Care Studies Group, Institute of Psychology Health and Society, University of Liverpool, Liverpool, United Kingdom
*
Author for correspondence: Oscar Rodríguez-Mayoral M.D., M.BETH, Servicio de Cuidados Paliativos, Instituto Nacional de Cancerología (INCan), Av. San Fernando No. 22 Col. Sección XVI, Delegación Tlalpan, C.P. 14080 Mexico City, Mexico. E-mail: orodriguezm@incan.edu.mx

Abstract

Objective

Depression in palliative advanced cancer patients is common, but often goes unrecognized. One of the first steps toward improving detection is the development of tools that are valid in the specific language and setting in which they are to be used. The Brief Edinburgh Depression Scale (BEDS) is a sensitive case-finding tool for depression in advanced cancer patients that was developed in the United Kingdom. There are no validated instruments to identify depression in Mexican palliative patients. Our aim was to validate the Spanish-language version of the BEDS in Mexican population with advanced cancer.

Method

We conducted a cross-sectional study with outpatients from the palliative care unit at the Instituto Nacional de Cancerología in Mexico City. The Mexican BEDS was validated against a semistructured psychiatric clinical interview according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, classification criteria for major depressive disorder. The interviewer was blind to the BEDS score at the time of the assessment.

Result

Seventy subjects completed the scale and interview. Women represented 71.4% of the sample and median age of subjects was 56.5 years (range, 20–85 years). The prevalence of major depressive disorder according to the psychiatric interview was 20%. The most valid cutoff for defining a case of depression was a score ≥5 of 18 on the Mexican BEDS, which gave a sensitivity of 85.7% and specificity of 62.5%. The scale's Cronbach's alpha was 0.71.

Significance of results

Major depressive disorder is frequent in Mexican palliative patients. The Spanish-language Mexican version of the BEDS is the first valid case-finding tool in advanced cancer patients in this setting.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allende-Pérez, S & Verástegui-Avilés, E (2013) La Medicina paliativa y el paciente con cáncer [Palliative medicine and the cancer patient]. Gaceta Mexicana de Oncologia 12(4), 6466.Google Scholar
Alvarado-Esquivel, C, Sifuentes-Alvarez, A & Salas-Martinez, C (2014a). The use of the Edinburgh Postpartum Depression Scale in a population of teenager pregnant women in Mexico: A validation study. Clinical Practice & Epidemiology in Mental Health 10(1), 129132. https://doi.org/10.2174/1745017901410010129Google Scholar
Alvarado-Esquivel, C, Sifuentes-Alvarez, A & Salas-Martinez, C (2014b). Validation of the Edinburgh Postpartum Depression Scale in a population of adult pregnant women in Mexico. Journal of Clinical Medicine Research 6(5), 374378. https://doi.org/http://dx.doi.org/10.14740/jocmr1883wGoogle Scholar
Alvarado-Esquivel, C, Sifuentes-Alvarez, A & Salas-Martinez, C, et al. (2006) Validation of the Edinburgh postpartum depression scale in a population of puerperal women in Mexico. Clinical Practice and Epidemiology in Mental Health 2, 48. https://doi.org/10.1186/1745-0179-2-33Google Scholar
American Psychiatric Association (2014) DSM-5. Manual diagnóstico y estadístico de los trastornos mentales [Diagnostic and statistical manual of mental disorders (5th ed.)]. Mexico: Editorial Médica Panamericana.Google Scholar
Arrieta, Ó, Angulo, LP, Núñez-Valencia, C, et al. (2013) Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Annals of Surgical Oncology 20(6), 19411948. https://doi.org/10.1245/s10434-012-2793-5Google Scholar
Carr, D, Goudas, L, Lawrence, D, et al. (2002). Management of cancer symptoms: Pain, depression, and fatigue. Evidence Report/Technology Assessment No. 61 (prepared by the New England Medical Center Evidence-Based Practice Center under Contract No 290-97-0019). AHRQ Publication No. 02-E032. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
Chochinov, H (2001) Depression in cancer patients. The Lancet Oncology 2(8), 499505. https://doi.org/10.1016/S1470-2045(01)00456-9Google Scholar
Chochinov, HM, Wilson, KG, Enns, M, et al. (1994). Prevalence of depression in the terminally ill: effects of diagnostic criteria and symptom threshold judgments. American Journal of Psychiatry 151(4), 537540. https://doi.org/10.1176/ajp.151.4.537Google Scholar
Chochinov, HM, Wilson, KG, Enns, M, et al. (1997) “Are you depressed?” Screening for depression in the terminally ill. The American Journal of Psychiatry 154(5), 674676. https://doi.org/10.1176/ajp.154.5.674Google Scholar
Cox, JL, Holden, JM & Sagovsky, R (1987) Detection of postnatal depression. British Journal of Psychiatry 150(6), 782786. https://doi.org/10.1192/bjp.150.6.782Google Scholar
Fallowfield, L, Ratcliffe, D, Jenkins, V, et al. (2001) Psychiatric morbidity and its recognition by doctors in patients with cancer. British Journal of Cancer 84(8), 10111015. https://doi.org/10.1054/bjoc.2001.1724Google Scholar
Kroenke, K, Theobald, D, Wu, J, et al. (2010) The association of depression and pain with health-related quality of life, disability, and health care use in cancer patients. Journal of Pain and Symptom Management 40(3), 327341. https://doi.org/10.1016/j.jpainsymman.2009.12.023Google Scholar
Landa-Ramirez, E, Cardenas-Lopez, G, Greer, JA, et al. (2014) Assessment of depression in patients with terminal cancer and its application in the Mexican context: A review. Salud Mental 37(5), 415422. https://doi.org/http://dx.doi.org/10.17711/SM.0185-3325.2014.049Google Scholar
Lee, JH, Kim, T, Ko, Y, et al. (2009) 암 환자에서 우울증의 선별도구로서 단축형 에딘버러 우울증 척도의 한국 표준화 [The standardization of the Korean version of Brief Edinburgh Depression Scale as a screening tool for depression in cancer patients]. Korean Journal of Biological Psychiatry 16(2), 112120.Google Scholar
Li, M, Fitzgerald, P & Rodin, G (2012a) Evidence-based treatment of depression in patients with cancer. Journal of Clinical Oncology 30(11), 11871196. https://doi.org/10.1200/JCO.2011.39.7372Google Scholar
Li, M, Fitzgerald, P & Rodin, G (2012b) Evidence-based treatment of depression in patients with cancer. Journal of Clinical Oncology 30(11), 11871196. https://doi.org/10.1200/JCO.2011.39.7372Google Scholar
Lloyd-Williams, M, Cobb, M, O'Connor, C, et al. (2013) A pilot randomised controlled trial to reduce suffering and emotional distress in patients with advanced cancer. Journal of Affective Disorders 148(1), 141145. https://doi.org/10.1016/j.jad.2012.11.013Google Scholar
Lloyd-Williams, M, Dennis, M & Taylor, F (2004) A prospective study to determine the association between physical symptoms and depression in patients with advanced cancer. Palliative Medicine 18(6), 558563. https://doi.org/10.1191/0269216304pm923oaGoogle Scholar
Lloyd-Williams, M, Shiels, C & Dowrick, C (2007) The development of the Brief Edinburgh Depression Scale (BEDS) to screen for depression in patients with advanced cancer. Journal of Affective Disorders 99(1–3), 259264. https://doi.org/10.1016/j.jad.2006.09.015Google Scholar
Mehta, RD & Roth, AJ (2015) Psychiatric considerations in the oncology setting. CA Cancer J Clin 65(4), 299314. https://doi.org/10.3322/caac.21285Google Scholar
Mitchell, AJ, Chan, M, Bhatti, H, et al. (2011) Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. The Lancet Oncology 12(2), 160174. https://doi.org/10.1016/S1470-2045(11)70002-XGoogle Scholar
Mitchell, AJ, Meader, N, Davies, E, et al. (2012) Meta-analysis of screening and case finding tools for depression in cancer: Evidence based recommendations for clinical practice on behalf of the Depression in Cancer Care consensus group. Journal of Affective Disorders 140(2), 149160. https://doi.org/10.1016/j.jad.2011.12.043Google Scholar
Morita, T, Tsunoda, J, Inoue, S, et al. (1999) The Palliative Prognostic Index: A scoring system for survival prediction of terminally ill cancer patients. Supportive Care in Cancer 7(3), 128133.Google Scholar
Nunnally, JC & Bernstein, IH (1995) Teoría psicómetrica [Psychometric theory], 3rd ed. México: McGraw-Hill.Google Scholar
Oken, MM, Creech, RH, Tormey, DC, et al. (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology 5(6), 649656. https://doi.org/10.1097/00000421-198212000-00014Google Scholar
Prescott, AT, Hull, JG, Dionne-Odom, JN, et al. (2017) The role of a palliative care intervention in moderating the relationship between depression and survival among individuals with advanced cancer. Health Psychology 36(12), 11401146. https://doi.org/10.1037/hea0000544Google Scholar
Rayner, L, Price, A, Hotopf, M, et al. (2011) The development of evidence-based European guidelines on the management of depression in palliative cancer care. European Journal of Cancer 47(5), 702713. https://doi.org/10.1016/j.ejca.2010.11.027Google Scholar
Rhondali, W, Chirac, A, Celles, L, et al. (2014) Dépression et cancer en phase avancée: Concordance entre différentes stratégies de dépistage [Depression and advanced cancer: Agreement between different screening strategies]. Bulletin Du Cancer 101(2), 137143. https://doi.org/10.1684/bdc.2014.1897Google Scholar
Rhondali, W, Girard, R, Saltel, P, et al. (2012) Validity and acceptability of a French-language version of the brief Edinburgh depression scale. Progress in Palliative Care 20(1), 16. https://doi.org/10.1179/1743291X11Y.0000000018Google Scholar
Rhondali, W, Perceau, E, Berthiller, J, et al. (2012) Frequency of depression among oncology outpatients and association with other symptoms. Supportive Care in Cancer 20(11), 27952802. https://doi.org/10.1007/s00520-012-1401-3Google Scholar
Sharpe, M, Strong, V, Allen, K, et al. (2004) Major depression in outpatients attending a regional cancer centre: Screening and unmet treatment needs. British Journal of Cancer 90(2), 314320. https://doi.org/10.1038/sj.bjc.6601578Google Scholar
Walker, J, Hansen, CH, Martin, P, et al. (2014) Integrated collaborative care for major depression comorbid with a poor prognosis cancer (SMaRT Oncology-3): A multicentre randomised controlled trial in patients with lung cancer. The Lancet Oncology 15(10), 11681176. https://doi.org/10.1016/S1470-2045(14)70343-2Google Scholar
Wilson, KG, Chochinov, HM, Skirko, MG, et al. (2007) Depression and anxiety disorders in palliative cancer care. Journal of Pain and Symptom Management 33(2), 118129. https://doi.org/10.1016/j.jpainsymman.2006.07.016Google Scholar
Wilson, KG, Dalgleish, TL, Chochinov, HM, et al. (2016) Mental disorders and the desire for death in patients receiving palliative care for cancer. BMJ Supportive & Palliative Care 6(2), 170177. https://doi.org/10.1136/bmjspcare-2013-000604Google Scholar
Yates, JW, Chalmer, B & McKegney, FP (1980) Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer 45(8), 22202224. https://doi.org/10.1002/1097-0142(19800415)45:8<2220::AID-CNCR2820450835>3.0.CO;2-Q3.0.CO;2-Q>Google Scholar
Ziegler, L, Hill, K, Neilly, L, et al. (2011) Identifying psychological distress at key stages of the cancer illness trajectory: A systematic review of validated self-report measures. Journal of Pain and Symptom Management 41(3), 619636. https://doi.org/10.1016/j.jpainsymman.2010.06.024Google Scholar